For all of the runners out there who are dealing with incontinence, you are not alone. According to a recent survey of physically active women, leakage impacts activity level for at least 50% of women (1). Typically, the most common compensation strategies women use to stay dry are reducing activity intensity (e.g., not able to run as hard) and avoiding specific activities (e.g., high impact activities like skipping, jumping jacks, running/jogging, or the dreaded trampoline).
If you enjoy running as much as I do though, these compensation strategies simply will not do. Nothing is going to stop you from hitting the trail, and you deserve to be out running and stay dry. Today’s post will get you out running again so that you can move better and ultimately mom better.
There’s a lot of truth to this shirt from Goneforarun at our house.
In this post, I’ll share three different body awareness strategies that you can easily incorporate into your next run to improve how you move to decrease leakage. These strategies help keep you moving and avoid that dreaded advice of “just don’t run or don’t run too hard.” Plus, I’ll share two more bonus clinical pearls to help you stay dry next time you hit the trail.
Even if you aren’t experiencing incontinence, these tips should help you run better. Being mindful of your posture, even while running, is important for everyone.
Runners are a rare breed. Some might say they are simply crazy. They can be irrational. They often wake up in the wee morning hours to get miles in before the sun comes up. They bundle up on Christmas morning even in a blizzard. They don’t like to take days off. They push their bodies to physical and mental limits most would never even want to imagine. And they call this fun. I can say this because I’m a runner. I understand you. I can’t explain us very well to others, and that’s not the purpose of this post, but I want you to know, I get you. I see you.
Telling a true runner that they can’t run is similar to telling a two-year old that he’s watched enough episodes of Paw Patrol and that it’s time to take a nap. There is often a tantrum followed by defiance and him choosing to continue to watch anyways.
I recognize that telling you to stop running and to go see a pelvic floor therapist would be best for you and is what I should say. However, I also know what happens when I tell my son that he isn’t allowed to watch any more episodes and it’s time to turn the iPad off on a long road trip. I don’t want to hear his cries or your cries so here are three tips to incorporate into your next run to work towards dryer runs in the future.
First, lean forward slightly.
Consider the angle of your body. Are you running standing straight up?
This erect posture could increase stress on a diastasis recti and force downward on the pelvic floor. Try leaning forward slightly. To do this, keep a neutral spine and your rib cage stacked over your hips, but lean slightly forward at your hips. This means that the lean should come from hinging at your hips, not from rolling your shoulders forward. Envision yourself letting gravity allow you to fall forward ever so slightly as you run.
Not only does it decrease strain on a diastasis recti or a dysfunctional pelvic floor, but this more optimal posture allows your gluteus maximus muscle to engage more naturally. It’s more efficient to push yourself forward with your glutes than it is to pull yourself along with your hip flexors.
One benefit of this is that there is a direct correlation to increasing posterior pelvic floor muscles function (the back of your pelvic floor) when your glute max is working based on the idea of regional interdependence (2).
The other benefit of leaning forward is bladder position. By tilting your pelvis slightly forward (anterior pelvic tilt), your bladder tends to shift forward too so it is supported more by your boney pelvis. This decreases the work load of your pelvic floor muscles which are likely not functioning at their best because you have continued to read this far into the article so you must be interested. 😉 So if you aren’t willing to take a break from running to address your incontinence, at the very least, give your pelvic floor muscles a break while you run so they aren’t getting over worked. More importantly, work to train them when you aren’t running by doing kegels more effectively.
Second, untuck your bum.
If your butt is tucked under, you’re increasing the pressure and your risk of developing a pelvic organ prolapse. Running with a tucked bum causes a lot of force on your pelvic floor (3). It also prevents you from using your gluteus maximus effectively. See reason #1. If you aren’t able to find this position independently, try increasing the incline on the treadmill. This will force you to untuck your bum, find that forward lean, and ultimately use your glutes better in order that you don’t fall off the back of the treadmill!
Lastly, shorten your stride length.
You could try shortening your stride by taking smaller steps. Over-striding, or taking long strides, can lead to higher impact which increases the risk of stress incontinence.
You could also try changing your foot strike pattern (what part of your foot hits the ground first). Using a forefoot strike instead of a heel strike will decrease the ground reaction force. Again, an especially aggressive heel strike leads to higher impact and increases the risk of stress incontinence. *However, there are multiple other factors to consider when pondering changing your striking pattern. Without careful consideration on how to gradually do this, you could end up with other problems like foot pain due to plantar fasciitis.
And now for two final pearls of wisdom… These are not related to movement/posture/body awareness, but it is imperative that they are mentioned.
- Hydration: Do not allow yourself to be dehydrated. This strategy does not work to prevent incontinence. Fluid intake is irrelevant to the amount of leaking women experience (4). There is no increased risk of incidence of urinary incontinence with higher intake of fluids. Therefore, keep yourself hydrated. It’s just better for your health for so many reasons.
- Kegel, kegel, kegel: When the urge to go suddenly strikes you, stop, drop, and kegel. Okay, you don’t have to drop, but stopping and performing 5-10 reps of core connection breathing with a kegel as explained in “A better Way to Breathe and the Right Way to Kegel” can significantly impact your ability to delay that urge until you finish your run instead of trying to power through that urge.
For all those die hard runners who know better, but still won’t stop running, try these body awareness tips to see if being mindful of your posture and striding pattern will help you run better (without leaking), and ultimately mom better. And if they don’t work, then I really do encourage you to see a pelvic floor therapist for individual treatment recommendations. We all deserve to run dry!
1. Brennard E, et al. Urinary leakage during exercise: problematic activities, adaptive behaviors, and interest in treatment for physically active Canadian women. International Urogynecology Journal. April 2018, Volume 29, Issue 4, pp 497–503.
2. Podschun, Laura, et al. Differential diagnosis of deep gluteal pain in a female runner with pelvic involvement: a case report. The International Journal of Sports Physical Therapy. Volume 8, Number 4. August 2013 page 462-471.
3. Mattox TF, Lucente V. Abnormal spinal curvature and its relationship to pelvic organ prolapse. Am J Obstet Gynecol. 2000 Dec; 1381-4; discussion 1384.
4. Townsend, Mary K. et al. Fluid intake and risk of stress, urgency, and mixed urinary incontinence. Am J Obstet Gynecol. 2011 July ; 205(1): 73.e1–73.e6.